The incidence of acute chemotherapy-induced nausea and vomiting (CINV) is approximately 55.3 %, while delayed CINV affects up to 62.3 % of cancer patients [1]. These adverse effects can lead to a range of clinical and psychosocial implications, including reduced quality of life, anxiety, malnutrition, gastrointestinal disturbances, the need for parenteral nutrition, difficulties in performing daily activities, and lower adherence to chemotherapy treatment [2], [3].

Despite the effectiveness of antiemetic drugs in preventing vomiting, they generally have a limited effect on nausea [4]. This is because nausea is a more complex and subjective manifestation, involving multiple neurological and chemical pathways, whereas vomiting is primarily mediated by more direct physiological reflexes [4].

Traditional Chinese Medicine (TCM)-related practices have played an increasingly important role in comprehensive cancer treatment [5]. According to the findings of a systematic review, despite promising results regarding AA's efficacy in controlling CINV, existing evidence is insufficient to recommend its use in clinical practice [6]. Moreover, the lack of high-quality evidence and the heterogeneity among randomized clinical trials (RCTs) made it impossible to conduct a meta-analysis [6]. Therefore, more robust RCTs are needed to investigate the efficacy of AA in controlling CINV [6].

Conducting an RCT on AA for CINV management in the oncology setting raises important concerns, such as participant non-adherence, intervention acceptability, limitations imposed by patients' clinical severity, the possibility of adverse events, difficulties in recruitment and follow-up, as well as logistical challenges related to intervention implementation. These factors make a pilot study essential, as it allows for assessing potential methodological and procedural challenges [7].

This pilot study aimed to evaluate the feasibility of an AA protocol for CINV management in adult cancer patients. The specific objectives of this pilot study were related to assessing the adequacy of recruitment strategies, acceptability, strategies for intervention implementation, attrition and adherence, feasibility of instruments, intervention safety, and preliminary efficacy evaluation.